Abstract

Objective The objective of this study was to investigate the association of four-year changes in alcohol consumption with subsequent
risk of type 2 diabetes.

Research Design and Methods We prospectively examined 38,031 men from the Health Professionals Follow-up Study free of diagnosed diabetes or cancer in
1990. Alcohol consumption was reported on food frequency questionnaires and updated every four years.

Results A total of 1905 cases of type 2 diabetes occurred during 428,497 person-years of follow-up. A 7.5 g/day (∼half a glass) increase
in alcohol consumption over four years was associated with lower diabetes risk among initial nondrinkers (multivariable hazard
ratio [HR] 0.78; 95% confidence interval [CI] 0.60-1.00) and drinkers initially consuming <15 g/day (HR 0.89; 95% CI 0.83-0.96)
but not among men initially drinking ≥15 g/day (HR 0.99; 95% CI 0.95-1.02; Pinteraction < 0.01). A similar pattern was observed for levels of total adiponectin and hemoglobin A1c, with a better metabolic profile among abstainers and light drinkers who modestly increased their alcohol intake, compared
with men who either drank less or among men who were already moderate drinkers and increased their intake. Likewise, compared
to stable light drinkers (0-4.9 g/day), light drinkers who increased their intake to moderate levels (5.0-29.9 g/day) had
a significantly lower risk of type 2 diabetes (HR 0.75; 95% CI 0.62-0.90).

Conclusions Increases in alcohol consumption over time were associated with lower risk of type 2 diabetes among initially rare and light
drinkers. This lower risk was evident within a four-year period following increased alcohol intake.